Most industry cancer studies never see the light of day

I don’t think anyone can dispute that, all too frequently, clinical trials deliver mistaken results. That’s partly because it’s really hard to develop truly randomized trials in the real world. Sometimes a study suggests a drug is effective, or safe, and it later turns out not to be the case.

Unfortunately, that’s just how modern medical trials work.

Now let me don a cynical hat, and let’s say you’re a pharmaceutical company. This potential for “wrong answers” presents an opportunity: conduct a bunch of different studies on a drug and publish only those that show truly favorable results. So if you conduct five studies on Drug A, and only one finds it has any effectiveness, just publish that study.

But surely, you say, medicine doesn’t work this way. I wish I could report otherwise.

Most science journals require clinical trials to be registered in a federal database, ClinicalTrials.gov, before they will publish the results. So it’s possible to ask: How many studies that get entered into the database actually get published?

• Trials registered before September 1, 2004 were published 21 percent of the time

• Of the registered trials, those sponsored by clinical trial networks were published 59.0 percent of the time

• Of the registered trials, those sponsored by industry were published 5.9 percent of the time

• Among published studies, 64.5 percent reported the results as positive findings

It seems possible that a fraction of the studies registered before Sept. 2004 either weren’t completed yet. But still, according to this analysis, less than 6 percent of industry-sponsored studies were actually published, whereas considerably more independently financed studies were published.

The cynic in me suggests that, at times, the drug industry goes on a fishing expedition for positive results. The medical ethicist in Dr. Howard Brody says as much:

Nonetheless, this study provides substantial statistical backup for a phenomenon that we had feared all along was occurring–systematic suppression of negative studies by industry.

Those concerned about the quality and cost of medical care ought to take note of such studies as they tell us quite a bit about some of the problems in our current system of delivering care.